Snus helps reduce smoking related deaths in Sweden

Diagrams showing how snus has reduced smoking and smoking related diseases in Sweden (click to enlarge)

The EU is currently working on a revision of the Tobacco products directive. The primary goal of this directive is to reduce the harm to public health caused by smoking.

It is undisputed that smoking poses a major health problem, and there are a number of provisions in the directive that aim at getting fewer young people to start smoking in the first place: plain packaging, pictorial warnings, a ban on cigarette flavourings etc. Judging from the general mood in the European parliament, I would expect these measures to get the support from a large majority.

However, no matter how successful these actions will be in preventing young people from starting smoking, it will take decades before we will see any health improvements in the population from these actions alone.

The only way to get a positive health impact in the meanwhile is to get current smokers to quit.

Here is a letter (pdf) written by several independent public health specialists and addressed to the Swedish minister for public health. My position on snus is the same as theirs. They write:

There has been a remarkable success for public health in Sweden that deserves more recognition by policy‐makers. According to the most recent Eurobarometer survey, adult smoking prevalence in Sweden is just 13%. That is far lower than the EU average of 28% and the next closest member state at 23%. The reason for this is perfectly clear: it is that, in Sweden, snus has been widely used to quit smoking or as an alternative to cigarettes. Given that the risks associated with snus use are of the order of 95‐99% lower than for smoking, this has resulted in substantially reduced burdens of tobacco‐related disease (cancer, cardiovascular disease, emphysema) compared to other member states. Today’s low rates of smoking will translate to significant health benefits in future, relative to other member states.

Here is also a pdf with diagrams (from the same experts) that illustrate the success story of snus as a means for reducing smoking, and thus smoking related diseases, in Sweden.

Their policy recommendations, which I agree with, can be summarized:

Let the decision to ban or not ban oral tobacco become a matter for each member state – reflecting the diverse cultural traditions in tobacco use and the different attitudes to harm reduction.
Create a regulatory framework for all smokeless tobacco that would limit the toxic contaminants that potentially cause harm, that would be used by member states that decide to allow any form of oral tobacco.
Allow characterizing flavours in smokeless tobacco (but ban them in cigarettes).

We are all in complete agreement that the EU needs to adopt policies to reduce smoking and the harm it causes. It is my belief that this policy on snus and oral tobacco would help achieve that goal.

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Further scientific data on the health effects of snus

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Declaration of interest: I am a snus user, which has allowed me to cut down my smoking drastically, even though I have not stopped completely yet. My wife used to smoke, but gave it up completely several years ago by switching to eucalyptus flavoured snus.